Provider Demographics
NPI:1740732783
Name:DEVINE DENTISTRY, PLLC
Entity type:Organization
Organization Name:DEVINE DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-269-4209
Mailing Address - Street 1:4219 HILLSBORO PIKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3328
Mailing Address - Country:US
Mailing Address - Phone:615-269-4209
Mailing Address - Fax:615-383-1998
Practice Address - Street 1:4219 HILLSBORO PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3328
Practice Address - Country:US
Practice Address - Phone:615-269-4209
Practice Address - Fax:615-383-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty